01/20/04 NEWSLETTER carlstonmd.com
Hello Patients HOME
There is so much to write about.  The major item I am working on is a piece dealing with prion disease ("mad cow" etc).  Given the media flurry, I am sure most of you have learned enough to have more questions, so I'd like to describe a bit more fully what we know and what we don"t know.  Whenever I latch on to something I want to present to you in a more comprehensive way, other topics seem to pile up behind it.  This newsletter represents some of that overflow.

Best, Michael Carlston, M.D.
www.carlstonmd.com

In This Issue: INDEX
  • PATIENT WISDOM
  • REFERRALS
  • LEARNING DISABILITY AND RADIATION
  • MALE INFERTILITY AND PLASTICS
  • HOW IS YOUR BRAIN WORKING
  • THAT OLD SMALLPOX VACCINE ISN'T GOING AWAY
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    PATIENT WISDOM TOP
    One of the great gifts of being a physician is the opportunity I have to absorb the wisdom accumulated by my many patients.  I think physicians are, in many ways, smarter when we begin our clinical practice, but wiser as we age.  When we are fresh out of training we know all of the latest technology and theory, but lack understanding of what really works.  That acquired wisdom chiefly derives from the experiences we share with patients.  Occasionally, a patient who has struggled with great adversity says something that can teach many of us.  The other day, a woman who has worked hard to overcome a difficult past, including tremendous anxiety, said to me, "I chose to stop living in the wreckage of my future".  She adapted this from something she had learned from the AA programs.  She meant that she had realized she was spending her life trying to cope with horrors that might come to pass.  She understood that dwelling on them and preparing for them didn't make the future much better, and certainly made the present more unpleasant.
    REFERRALS TOP

    I want to thank you all for your referrals of friends, family and coworkers.  The decline in the local and national economy has forced many people to try to cut back on their expenses.  Unfortunately, that includes health care that falls outside of the HMO machinery; for example, yours truly.  Added to the pre-existing difficulties in the local medical economics (the Sonoma County insurance reimbursement rates set at rural, not Bay Area, expense levels that had forced many of the best local conventional physicians to move away) this could have forced me also to move elsewhere.  I have not, because you continue to support my commitment to providing you with individualized attention to your wellbeing.

    Although my approach could be seen as a luxury by some, you recognize the benefit of avoiding overuse of medication and working to prevent illness through the use of homeopathy, herbs and good lifestyle habits. Not only does this approach demand more of me than conventional medicine, it also requires more of your time and commitment.

    Thank you for your support of my practice as well as this philosophy.  I promise to continue learning and doing my best to provide you with the very best possible health care.
    LEARNING DISABILTY AND RADIATION TOP
    Add learning disabilities to the list of potential ill effects from radiation.  The famous Karolinska medical research institution in Sweden investigated the learning abilities of 2,000 children treated with radiation for birthmarks.  The children received a radiation dose to their heads equivalent to that of a CT scan. Researchers learned that children with birthmarks who received this radiation treatment were significantly more likely to have learning difficulties than untreated children.
    MALE INFERTILITY AND PLASTICS TOP
    For decades the average male sperm count has been dropping.  Average numbers today were considered infertile 40 years ago.  It appears that a widespread chemical used in plastics and cosmetics might be an important factor in this decline.  The class of chemicals called phthalates mimic estrogens, and recent studies show they depress sperm counts.  One use of phthalates is to make plastics more flexible.  Some of you may remember that there was a big fuss several years ago when the potential for phthalates was first recognized.  At the time, essentially all baby pacifiers were made with phthalates.  After the discovery, the baby pacifiers were quickly taken off the market.
    HOW IS YOUR BRAIN WORKING TOP
    A few months ago I announced that I had begun to offer computerized cognitive testing for athletes.  This test is the most accepted computerized procedure worldwide to assess the effects of head injuries. The group that developed the test has now adapted it for use in the aging population.  We can use it to establish a baseline measure of memory and cognitive function which can then be used as a comparison with the passage of time.  This should enable us to identify problems with mental functioning at an earlier stage and so intervene to prevent or slow further decline.
    THAT OLD SMALLPOX VACCINE ISN'T GOING AWAY TOP
    Helping allay some of the terrorist anxiety gripping our country, new research shows that fears about smallpox immunity waning are unwarranted.  Testing blood immunity factors researchers found that 90% of those immunized even 50 years ago are still immune.  As the youngest members of our population were never immunized, it is not certain however, that there are enough of us who remain immune to thwart any spread of smallpox through the country.  If enough members of a group are resistant to an infection, that infection just can not spread through that population.
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